Office of Student Accommodations
Placement Test Form
Enter Student ID# then press Tab * - Required field
*Student ID#:    
*First Name: *Last Name:
Phone: *Reynolds Email:
*Term:                The campus I want to take the placement test on:   
*Placement Test to be taken:     

Requested Accommodations
At least one accommodation must be selected


Preferred Test Dates
Please indicate three test date options

*First Preferred Test Date: *First Preferred Test Time:
*Second Preferred Test Date: *Second Preferred Test Time:
*Third Preferred Test Date: *Third Preferred Test Time: